Of course, gynecological diseases in girls and girls are less common than in adult women, but they still occur. It means that they should be noticed and eliminated in time.
Otherwise, in the future, problems may arise that are completely not childish.
Examinations at the gynecologist are planned and unscheduled.
The very first routine gynecological examination is carried out immediately after the birth of the baby when the child’s sex is identified.
The second routine examination at the children’s gynecologist is carried out at 3 years old, when most children go to kindergarten and draw up a medical card. Further, it is desirable to show the girl to a pediatric gynecologist before entering the first grade and at the age of 11-12, when the majority of girls begin to establish a menstrual cycle.
If the doctor does not notice developmental abnormalities, while the mother and the child have no complaints, then from 15-16 years old it is advisable to visit the gynecologist once a year.
If there are complaints, the girl should be shown to the gynecologist out of schedule.
Doctors recommend mothers, having received a baby at their disposal, to carefully examine the genitals of the newborn daughter and ask the doctor if everything is in order with them. It is necessary for a woman to understand how they should look, notice the changes and show the girl to the doctor in time.
In a full-term girl, the labia majora covers the small lips. The clitoris is considered to be of normal size if it does not protrude beyond the genital slit – the slit-like opening between the labia majora leading to the eve of the vagina. An enlarged clitoris, which is visible to the naked eye, can be a sign of congenital dysfunction of the adrenal cortex or a chromosomal disease.
Such abnormalities require urgent consultation with a pediatric gynecologist and pediatric endocrinologist. Only a pediatric gynecologist and pediatric endocrinologist can choose the right treatment regimen.
Another serious problem is premature sexual development. It is said about it, if a girl under 8 years old has breast enlargement, pubic hair or armpits begin to grow hair and blood discharge from the genital tract appears. Very rarely, similar phenomena can be observed in 4-5-year-old babies, who normally have a hormonal system at rest.
Gross abnormalities in height and weight of a girl can also be a symptom of gynecological problems.
Only a pediatric gynecologist and pediatric endocrinologist can correctly assess the condition, make a diagnosis, determine the cause of deviations from the norm and prescribe therapy.
1. Vaginitis in a girl
Most often at this age inflammation of the vagina and its entrance, that is, vulvovaginitis, occurs. This disease occurs due to the fact that girls have mucous membranes are very thin and can not fully protect the genitals from infection.
Symptoms: redness and inflammation of the vaginal opening, whitish discharge from the genital tract.
Treat the disease should be a pediatric gynecologist. He examines the girl on the couch or in the hands of her mother and takes strokes from the entrance to the vagina for flora and hidden infections. The first study determines the presence and number of pathogenic bacteria, the second – allows you to identify microorganisms that are not detected in the analysis of flora.
About inflammation says an increased number of leukocytes in the smear. If the culprit was not found, PCR diagnostics are performed.
Depending on which microorganisms caused the inflammation, antifungal or antibacterial therapy is carried out.
2. Fusion of small or large labia.
The risk of fusion is very high with vulvovaginitis. In this case, a gentle leathery bridge between the small or large labia – synechia.
Sometimes it covers the entrance to the vagina or urethra. You can suspect this if the urine stream changes the right direction.
The girl can straighten when urinating, acting up. To understand what’s the matter, it is enough to examine the girl’s genitals. In the treatment of synechia, estrogen-containing ointments and gels are very effective.
The operations are practically not done now, because they do not provide a guarantee of complete cure and often lead to the formation of rough scars.
It may be a consequence of vulvovaginitis, vaginal dysbacteriosis, or hypothermia. A girl is examined by a gynecologist, a urine test is taken from her and a seeding is done on the sensitivity of the vaginal microflora to antibiotics.
According to its results, antibiotic treatment is prescribed.
A girl may become infected with yeast-like fungi from a mother during childbirth — as she passes through the birth canal. Symptoms: itching, burning, marked redness of the external genital organs and cheesy discharge from the genital tract.
Sometimes the incubation period lasts 4-5 years, and even longer.
This disease should also be treated by a pediatric gynecologist. Inspection scheme is the same as with vulvovaginitis.
Treatment is prescribed based on the results of examination and examination of smears from the vaginal opening on the flora and hidden infections.
1. Juvenile bleeding.
It occurs in the period when the girl is the establishment of the menstrual cycle. It can be caused by stress, physical exertion, diseases of internal organs.
Often the occurrence of juvenile bleeding is triggered by prolonged exposure to the body of solar radiation or diseases that are accompanied by a prolonged increase in temperature.
The absence of a normal menstrual cycle. If a girl of 15-16 years old has no menstruation, they talk about primary amenorrhea.
It can be inherited (late onset of menstruation in relatives), it can be caused by hormonal imbalances, developmental malformations of the internal organs (uterus, ovaries), and diseases of the endocrine system.
If the menstrual cycle is established, but then the menstruation is stopped, we are talking about secondary amenorrhea. It can cause as serious violations (for example, tumors of the ovaries or pituitary), and stress, physical exertion, sharp weight loss of the girl.
In no case can not let these phenomena take their course. Consultation of the children’s gynecologist in this case is obligatory. Having examined the girl, the doctor will recommend to take a blood test for hormones, to consult an endocrinologist, to make an ultrasound of the pelvic organs.
According to the survey results, hormone therapy is prescribed or vitamin medication is recommended.
Endometriosis, or the proliferation of uterine cells (endometrium) beyond the uterus. The endometrium areas that are not in their place during menstruation bleed the same way as the endometrium in the uterus.
You can suspect such a violation if during the menstruation or immediately after them the girl experiences severe pain.
Only a pediatric gynecologist can make an accurate diagnosis and determine the treatment regimen based on the results of a gynecological examination before, during and after menstruation, and also an ultrasound of the pelvic organs.
4. Cysts, tumors.
Acute or chronic abdominal pains or a change in its shape and size in a girl can also be a reason for referring to a pediatric gynecologist. The cause of this condition may be a cyst or ovarian tumor. It is determined by the results of ultrasound of the pelvic organs.
In this case, the girl should be under the supervision of a pediatric gynecologist. Only he can decide whether surgery is necessary, or recommend the use of appropriate drugs.
5. Inflammation of the uterus.
At the same sensitive age, inflammation of the uterine appendages – the ovaries, ligaments and fallopian tubes is possible. In girls, this is most often caused by a weakened immune system. The daughter’s complaints about strong aching pains in the right and left lower abdomen, which increase during menstruation, should alert the mother.
Used for the treatment of antispasmodics, antibiotics and anti-inflammatory drugs. Often used antihistamines, multivitamin complexes and physiotherapy.
Pediatric gynecologist prescribes therapy, focusing on the results of ultrasound of the pelvic organs, pelvic examination. Other studies may be prescribed.
A gynecological examination of girls under the age of 15 is carried out only in the presence of a mother or another legal representative of the child (for example, a grandmother). The main task of the mother is not to be nervous during the examination and to prepare the girl for the procedure.
Tell your daughter that you, too, regularly undergo examinations with such a doctor. It is necessary for health, so that nothing hurts inside.
Explain that the doctor may want to look at her on the chair. Explain how to salit properly on the chair, where to put the legs.
Say that this is the most common procedure.
Tell that the doctor will talk with you and with your daughter. Explain what questions he will ask and what should be answered without hesitation.
In any case, the pediatric gynecologist will do an external examination to determine whether the mammary glands and external genitalia are developing properly. To do this, the doctor will ask the child to lie on his back on the couch and slightly spread his legs (the so-called frog pose). If earlier in the presence of complaints, the doctor performed an anal examination (a finger was inserted into the anus, and the doctor felt his stomach with his left hand, so he examined the uterus and ovaries), now more often the examination is carried out with the help of specially adapted for children gynecological instruments that do not cause discomfort and not violating the anatomy of the girl.
A smear from a child is taken only from the external genital lips, without inserting the wand inside.
In a teenage girl, the doctor will inquire about the time when her periods began, when she had her last period, how regular her periods are. In order not to forget anything, it is better to write the answers in advance and then read them to the doctor.
The gynecologist should definitely report that menstruation takes place with long breaks, or too long, or with irregular breaks, that they are painful, etc.
Usually, a gynecologist needs a clean diaper or a small towel to check on a chair under the ass, socks so as not to go barefoot to the chair and from it to the couch where the clothes lie.
Careful observance of the rules of hygiene and holding an intimate girl’s toilet will help prevent inflammatory diseases of the girl’s genital area.
To the girl did not have redness and discharge, it is necessary to wash it from front to back. In babies, this procedure is carried out with each change of diapers. Older girls – in the morning and in the evening.
At the same time it is necessary to push the labia lips slightly. With soap (neutral or childish), the baby is washed only after a bowel movement.
Moisture after washing is not wiped, but wetted with a waffle white towel: the dye can cause an allergic reaction, and even a small villus – irritation. For the same reasons, the use of paper napkins and cotton swabs is not recommended.
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